How to Use SmartPrep

Triggering CEMRA with SmartPrep
How to Use SmartPrep
This section provides the step-by-step instructions for using
SmartPrep. Specifically, it describes how to:
•
Scan with SmartPrep
° Patient Preparation and Scan Set Up
° Placing the Tracker Volume
° Placing the Imaging Volume
° Scanning the series
3-12 \ Signa LX/i 8.3 Reference Manual 2275080-100 Rev 0
© Copyright 2000 GE Medical Systems
How to Use SmartPrep
Anchor
Scanning with SmartPrep
Patient Preparation and Scan Start Up
In Brief: Scanning
with SmartPrep
1. Select the appropriate
coil.
2. Position the patient
comfortably and
immobilize the area of
interest.
3. As directed by physician,
set-up the patient IV
catheter, contrast, saline
and power injector
(optional).
4. Landmark the patient and
press [Move to Scan].
5. Acquire an appropriate
localizer series.
6. Select [New Series].
Then [Pt. Position].
7. Select [Oblique], [3D]
and [Fast TOF GRE] or
[Fast TOF SPGR].
8. Select [SmartPrep] and
other appropriate on
imaging options screen.
NOTE: Select [Multiphase]
to capture both
arterial & venous
phases.
9. Complete the scan
prescription. (Timing
parameters, FOV, matrix
and slice thickness).
Use this procedure to setup a SmartPrep series. By using
SmartPrep, the system will prompt you when to begin giving
contrast and will automatically start the scan for you. This takes
the guesswork out of CEMRA timing, reducing the chances of
missed boluses.
You should already know how to set-up a protocol for your
system, only a brief review will be explained. The rest of the
procedure will guide you through the SmartPrep setup process.
1. Select an appropriate coil.
•
Use SmartPrep for CEMRA of the carotids, thoracic
aorta, abdominal aorta, celiac axis, SMA, renals, iliacs
and lower extremity vessels.
•
See Volume 1, Chapter 3 for some suggested coil
positioning.
2. Make the patient comfortable and immobilize the area of
interest with sponges.
3. As directed by the physician, set-up the patient IV catheter,
and prepare the power injector (optional), according to your
system specifications.
4. Landmark the patient and press the [Move to Scan]
button.
5. Acquire an appropriate localizer series.
NOTE: Sometimes more than one localizer is needed to make
sure proper volume coverage is included.
6. After localizer is reconstructed, select [New Series] button.
7. Then click [Pt. Position] button. Select [Oblique], [3D]
10. Select [User CV] to enter
SmartPrep imaging
parameters.
© Copyright 2000 GE Medical Systems
Signa LX/i 8.3 Reference Manual 2275080-100 Rev 0/ 3-13
Triggering CEMRA with SmartPrep
NOTE: You can prescribe a coronal orthogonal plane, just make
sure volume includes the necessary imaging anatomy.
In Brief: Scanning
with SmartPrep Cont.
8. Select [Fast TOF GRE] or [Fast TOF SPGR] from the pulse
sequences pull down menu. Select [SmartPrep] from the
imaging options menu.
NOTE: Enter correct contrast
dosage.
NOTE: Select [Multiphase] button if you want both the arterial
and venous phase. See Volume 3, Chapter 1 for more
detail on this option.
11. Select the appropriate
series and image. Then
click [Graphic RX].
12. Click on the [Tracker].
13. Place tracker over the
entry/main vessel.
14. Click [Graphic Rx].
15. With the left mouse click
on image. Angle 3D
volume to desired
position. Click [Fallback]
if necessary. Then click
[Accept] and [Save
Series].
16. Clear Message log.
17. Click on [Prepare to
Scan], then [Auto
Prescan].
18. Now click on [Scan] and
watch message window
area.
19. Begin giving contrast
when you see "Inject
Contrast" message.
20. When you see the "Bolus
Detected" message or
hear the audible switch in
the gradients, instruct the
patient to hold his/her
breath.
9. Complete the scan prescription
° Select the scan timing parameters to minimize TR and
TE.
° Select FOV, matrix and slice thickness to balance spatial
resolution and SNR.
° Minimize scan time to allow for breath-held acquisitions.
10. Fill in the SmartPrep Imaging Parameters under the [User
CV] button.
° To ensure that SPECIAL and Burst Scan Time/Turbo
modes are on a ’1’ should be entered in the space
provided. To ensure that these options are off a ’0’
should be entered.
NOTE: Remember to enter the correct contrast dosage. See
section on Threshold for more detailed information.
Scanning with SmartPrep
Placing the Tracker Volume
11. Select the appropriate series and image, then click
[Graphic RX].
Something to Think About...
•
Sometimes it is best to use an axial slice to place the
tracker, this way you can see the anterior and posterior
portion of the vessel you are placing it in.
•
Recommended typical tracker volume is 2 x 2 x 2 cm.
This helps to minimize tracker movement.
12.Once the Graphic RX screen appears, select [Tracker].
3-14 \ Signa LX/i 8.3 Reference Manual 2275080-100 Rev 0
© Copyright 2000 GE Medical Systems
How to Use SmartPrep
13.Place the tracker pulse over the entry/main vessel by
clicking left mouse button, no farther than 1/4 of the FOV
above or below the center of the FOV.
NOTE: The tracker should be contained completely inside the
vessel.
Scanning with SmartPrep
Placing the Imaging Volume
14. Now select the [Graphic RX] and the appropriate series
and image.
15. Place the cursor in the image and with the left mouse button
click on the image. A 3D volume should appear.
NOTE: A midline slice is best for setting up your imaging
volume, unless your patient is off center inside the
magnet.
16. Make adjustments to the angle, if oblique plane is chosen,
to insure proper coverage of anatomy. Select [Fallback] if
necessary. Make sure the tracker is contained completely
inside the imaging volume.
© Copyright 2000 GE Medical Systems
Signa LX/i 8.3 Reference Manual 2275080-100 Rev 0/ 3-15
Triggering CEMRA with SmartPrep
NOTE: Failure to include tracker completely inside the imaging
volume will result in SmartPrep failing to detect bolus.
17. Click the [Accept] button when done.
Scanning with SmartPrep
Scanning the Series
18. Clear the message log. You can do this by simply left mouse
clicking on the message window and clicking [Clear]
button. Then select [Save Series].
19. Click the [Prepare to Scan]. Then [Auto Prescan].
20. Click [Scan] and watch the message window area.
NOTE: Do not inject contrast until prompted.
21. The first message to appear will be "Acquiring Baseline
Data." This message will then be followed by "Inject
Contrast." Now you can begin giving contrast.
Baseline
Phase
Monitor
Phase
Scan
Phase
Do Not Inject
Inject
Breath
Patient
During
Delay
22. When the "Bolus Detected" message appears and/or you
hear the audible switch of the gradients, instruct the patient
to hold his/her breath. Allow scan to complete.
3-16 \ Signa LX/i 8.3 Reference Manual 2275080-100 Rev 0
© Copyright 2000 GE Medical Systems